Association between executive functions and fear of falling among people aged 80 years or older: a cross-sectional study

Abstract Objectives Fear of falling (FoF) is a common problem among older adults. It can lead to reduced quality of life and less physical activity, which increases fall risk. Earlier work has shown that FoF can be a manifestation of executive dysfunction in adults over 50 years, but studies on peop...

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Main Authors: Anna Awad, Anna Sundström, Felicia Gramner, Ursula Werneke, Annika Toots, Birgitta Olofsson, Albin Dahlin Almevall, Erik Rosendahl, Stefan Söderberg, Yngve Gustafson, Johan Niklasson
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-06067-5
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Summary:Abstract Objectives Fear of falling (FoF) is a common problem among older adults. It can lead to reduced quality of life and less physical activity, which increases fall risk. Earlier work has shown that FoF can be a manifestation of executive dysfunction in adults over 50 years, but studies on people over age 75 years are lacking. Executive functions (EFs) are cognitive functions associated with the frontal lobes and the prefrontal cortex. The aim of this study was to assess associations of EFs and FoF among people aged 80 years or older. Methods This cross-sectional study was based on data from the Northern Sweden Silver-MONICA study and included 434 participants aged 80 years or older. EFs were assessed with the Frontal Assessment Battery (FAB) and FoF with the Falls Self-Efficacy Scale–International (FES-I). Multivariable linear regression analysis was used to examine associations among EF, FoF, and a comprehensive set of adjustment factors. Pearson correlation analysis was used to evaluate associations of FES-I and the subitems of the FAB. Results EFs as measured by FAB were inversely associated with FoF (β = -0.23; 95% confidence interval, -0.42 to -0.03; p = 0.021), even after comprehensive adjustments. The FAB subitems measuring lexical fluency, inhibitory control, sustained attention, self-organization, motor programming, and planning also were inversely associated with FoF. Conclusions Lower EF is associated with higher FoF among people aged 80 years or older. This information is important for treating and preventing FoF in this population.
ISSN:1471-2318